The view from inside major medical centers
KELLY: We are going to get back to some of that. I think that raises a really interesting topic. Frank, can you talk about your experience at Cleveland?
PEACOCK: Sure, the issues I see with all of this become one of surge, and the secretary talked about that, and that becomes a critical issue. And we have a drill every year in this country; it's called February. And in February we have our normal flu season, and you can go to any city in the United States and see ambulances diverted from hospitals because our margins are so skinny. We live on a just-in-time, deliver-it-now we look like a car company. That is the American hospital system that we use.
The problem is, is we are just good enough for what happens now, and the idea of doubling our infrastructure, which will take a tremendous amount of revenue isn't going to happen because if you just look at hospital numbers over the last decade, we close hospitals all of the time. I have been in Cleveland for a decade; we have closed three hospitals since I got there. They are not closing because they have bails of money laying around; they are closing because we're we have turned it into a business and we have squeezed it to the tightest margin we can, and now we are going to double our infrastructure for nothing because we can't get money from a moth-balled hospital, but when we talk about pandemic flu, we need to double our beds. We have trouble now managing flu in February across the country.
So, you know, I really do appreciate that all things are local, that if we have a pandemic you are going to take care of it on a local business. All emergency medicine is local; I don't care where your hospital is. But we need to have a comprehensive plan across the nation for improving infrastructure. This is otherwise we can't go anywhere.
The other piece of this that is important is the safety. And there was the article, Vicki, you showed me today, in the paper, which shows that people won't show up, and that is absolutely critical. And if you don't have the hospital as regarded as a safe oasis, people don't come to work. And that is something we have worked hard at doing, is establishing the fact that if you if there is a flu epidemic, the best place to go is the hospital, that you have got the respirators, and you have got the masks and the things that you need so people show up at work because otherwise you may have a good building but nobody is in it.
KELLY: Thanks, Frank. Vicki?
RUNNING: Mainly at Stanford, we focus on the practical and try to focus on what is concrete and what we can do. We understand, being in an earthquake area, that there are often events that impact our facility. And a pandemic is actually quite different than those types of events. In a pandemic situation, you have staffing issues. While we may have 30 or 40 or 50 maybe 80 or 100 ventilators available in the county, we may not have the staff to be able to manage those ventilators effectively and provide the quality of care that we would like to provide anytime there is someone that is ill.